The journal of nutrition, health & aging

, Volume 15, Issue 10, pp 933–938

Timed up and go test and risk of falls in older adults: A systematic review

  • Olivier Beauchet
  • B. Fantino
  • G. Allali
  • S. W. Muir
  • M. Montero-Odasso
  • C. Annweiler
JNHA: Geriatric Science

Abstract

Objective

To assess the association and the predictive ability of the Timed Up and Go test (TUG) on the occurrence of falls among people aged 65 and older.

Methods

A systematic English Medline literature search was conducted on November 30, 2009 with no limit of date using the following Medical Subject Heading (MeSH) terms “Aged OR aged, 80 and over” AND “Accidental falls” combined with the terms “Timed Up and Go” OR “Get Up and Go”. The search also included the Cochrane library and the reference lists of the retrieved articles.

Results

Of the 92 selected studies, 11 met the selection criteria and were included in the final analysis. Fall rate ranged from 7.5 to 60.0% in the selected studies. The cut-off time separating non-fallers and fallers varied from 10 to 32.6 seconds. All retrospective studies showed a significant positive association between the time taken to perform the TUG and a history of falls with the highest odds ratio (OR) calculated at 42.3 [5.1–346.9]. In contrast, only one prospective study found a significant association with the occurrence of future falls. This association with incident falls was lower than in retrospective studies.

Conclusions

Although retrospective studies found that the TUG time performance is associated with a past history of falls, its predictive ability for future falls remains limited. In addition, standardization of testing conditions combined with a control of the significant potential confounders (age, female gender and comorbidities) would provide better information about the TUG predictive value for future falls in older adults.

Key words

Timed up and go falls older adults 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–148.PubMedGoogle Scholar
  2. 2.
    Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29:64–68.PubMedCrossRefGoogle Scholar
  3. 3.
    American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopedic Surgeons panel on falls prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49:664–772.CrossRefGoogle Scholar
  4. 4.
    Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med. 2003;348:42–49.PubMedCrossRefGoogle Scholar
  5. 5.
    Yeung TS, Wessel J, Stratford PW, MacDermid JC. The timed up and go test for use on an inpatient orthopaedic rehabilitation ward. J Orthop Sports Phys Ther. 2008;38:410–417.PubMedGoogle Scholar
  6. 6.
    Beauchet O, Annweiler C, Dubost V, Allali G, Kressig RW, Bridenbaugh S, Berrut G, Assal F, Herrmann FR. Stops walking when talking: a predictor of falls in older adults? Eur J Neurol. 2009;16:786–795.PubMedCrossRefGoogle Scholar
  7. 7.
    Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896–903.PubMedGoogle Scholar
  8. 8.
    Gunter KB, White KN, Hayes WC, Snow CM. Functional mobility discriminates nonfallers from one-time and frequent fallers. J Gerontol A Biol Sci Med Sci. 2000;55:M672–M66.PubMedCrossRefGoogle Scholar
  9. 9.
    Rose DJ, Jones CJ, Lucchese N. Predicting the probability of falls in community-dwelling older adults using the 8-foot Up-and-Go: a new measure of functional mobility. J Aging Physical Activity. 2002;10:466–475Google Scholar
  10. 10.
    Chiu AY, Au-Yeung SS, Lo SK. A comparison of four functional tests in discriminating fallers from non-fallers in older people. Disabil Rehabil. 2003;25:45–50.PubMedGoogle Scholar
  11. 11.
    Thomas JI, Lane JV. A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients. Arch Phys Med Rehabil. 2005;86:1636–1640.PubMedCrossRefGoogle Scholar
  12. 12.
    Thrane G, Joakimsen RM, Thornquist E. The association between timed up and go test and history of falls: the Tromsø study. BMC Geriatr. 2007;7:1.PubMedCrossRefGoogle Scholar
  13. 13.
    Arnold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr. 2007;7:17.PubMedCrossRefGoogle Scholar
  14. 14.
    Okumiya K, Matsubayashi K, Nakamura T, Fujisawa M, Osaki Y, Doi Y, Ozawa T. The timed “up & go” test is a useful predictor of falls in community-dwelling older people. J Am Geriatr Soc. 1998;46:928–930.PubMedGoogle Scholar
  15. 15.
    Lindsay R, James EL, Kippen S. The Timed Up and Go Test: unable to predict falls on the acute medical ward. Aust J Physiother. 2004;50:249–251.PubMedGoogle Scholar
  16. 16.
    Large J, Gan N, Basic D, Jennings N. Using the timed up and go test to stratify elderly inpatients at risk of falls. Clin Rehabil. 2006;20:421–428.PubMedCrossRefGoogle Scholar
  17. 17.
    Beauchet O, Allali G, Annweiler C, Berrut G, Maarouf N, Herrmann FR, Dubost V. Does change in gait while counting backward predict the occurrence of a first fall in older adults? Gerontology. 2008;54:217–223.PubMedCrossRefGoogle Scholar
  18. 18.
    Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE initiative. The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344–349.CrossRefGoogle Scholar
  19. 19.
    Mackinnon A. A spreadsheet for the calculation of comprehensive statistics for the assessment of diagnostic tests and inter-rater agreement. Comput Biol Med. 2000;30:127–134: www.mhri.edu.au/biostats/DAG_Stat/ PubMedCrossRefGoogle Scholar
  20. 20.
    Siggeirsdóttir K, Jónsson BY, Jónsson H Jr, Iwarsson S. The timed ‘Up & Go’ is dependent on chair type. Clin Rehabil 2002;16:609–616.PubMedCrossRefGoogle Scholar
  21. 21.
    Cummings SR, Nevitt MC, Kidd S. forgetting falls: the limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988;36:613–616.PubMedGoogle Scholar
  22. 22.
    Montero-Odasso M, Schapira M, Soriano ER, Varela M, Kaplan R, Camera LA, Mayorga LM. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2005;60:1304–1309.PubMedCrossRefGoogle Scholar
  23. 23.
    Morris R, Harwood RH, Baker R, Sahota O, Armstrong S, Masud T. A comparison of different balance tests in the prediction of falls in older women with vertebral fractures: a cohort study. Age Ageing. 2007;36:78–83.PubMedCrossRefGoogle Scholar
  24. 24.
    Nordin E, Lindelöf N, Rosendahl E, Jensen J, Lundin-Olsson L. Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff’s global judgement and fall history in evaluating fall risk in residential care facilities. Age Ageing. 2008;37:442–448.PubMedCrossRefGoogle Scholar
  25. 25.
    Bischoff HA, Stähelin HB, Monsch AU, Iversen MD, Weyh A, von Dechend M, Akos R, Conzelmann M, Dick W, Theiler R. Identifying a cut-off point for normal mobility: a comparison of the timed ‘up and go’ test in community-dwelling and institutionalized elderly women. Age Ageing. 2003;32:315–320.PubMedCrossRefGoogle Scholar
  26. 26.
    Tinetti M. Preventing falls in elderly persons. N Engl J Med 2003;348:42–49.PubMedCrossRefGoogle Scholar
  27. 27.
    Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol 1999;52:27–37.PubMedCrossRefGoogle Scholar
  28. 28.
    Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35Suppl 2:ii37–ii41.PubMedCrossRefGoogle Scholar
  29. 29.
    Moreland JD, Richardson JA, Goldsmith CH, Clase CM. Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2004;52:1121–1129.PubMedCrossRefGoogle Scholar

Copyright information

© Serdi and Springer Verlag France 2011

Authors and Affiliations

  • Olivier Beauchet
    • 1
    • 2
    • 3
    • 7
  • B. Fantino
    • 2
    • 3
    • 4
  • G. Allali
    • 5
  • S. W. Muir
    • 6
  • M. Montero-Odasso
    • 6
  • C. Annweiler
    • 1
    • 2
    • 3
  1. 1.Department of Internal Medicine and GeriatricsAngers University HospitalAngersFrance
  2. 2.Angers University Memory CenterAngersFrance
  3. 3.UPRES EA 2646University of Angers, UNAMAngersFrance
  4. 4.Medical Health CenterCNAMTSLyonFrance
  5. 5.Department of NeurologyGeneva University Hospital and University of GenevaGenevaSwitzerland
  6. 6.Department of Medicine, Division of Geriatric MedicineUniversity of Western OntarioLondonCanada
  7. 7.Department of Internal Medicine and GeriatricsAngers University HospitalsAngers cedex 9France

Personalised recommendations